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celinemargo posted:
so i missed my period from last month and until now i haven't got it. the last time was on the last week of december. the thing is i've been single for a year now and the last intercourse i had was back in 2011. but ever since that happened, i always got my period regularly and since then i NEVER had sex with anyone till now. i went to my doctor the other day and told him that he asked me to do some bloodwork and i work in a lab , i'm a technician so i am aware of which test he asked me to do. he would like to check my cbc my b12 , iron and my tsh and t3&t4. im still waiting for the results to come. im just being anxious on what will be the reason is. im checking for all the pregnancy symptoms are but i am sure that i haven't have those except my missed period.

BTW im working 2jobs right now which basically i work literally 7 days a week. and due to some changes of my working schedule im thinking if this could be the reason.

AM I JUST STRESS? or what?

HELP PLEASE
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Jane Harrison Hohner, RN, RNP responded:
Dear celinemargo (beautiful name!!): In terms of the blood work that was ordered, the most salient for a work up for amenorrhea (missing periods) would be the TSH with the T3 and T4 for additional input. Thyroid problems, especially hypothyroid, can readily cause missed periods because low thyroid with interfere with ovulations.

As you may have read, once pregnancy has been ruled out, then the next most common cause of a missed period is not having ovulated that cycle. In a normal cycle, estrogen is produced all month. Estrogen is responsible for building up the lining of your uterus so you have something to shed each month.

In a normal cycle, progesterone production increases following ovulation. Progesterone "stabilizes" the uterine lining in preparation for a possible implantation of a new pregnancy. If you are not pregnant that month the levels of estrogen and progesterone fall, triggering the release of the uterine lining—your period.

So, if you do not ovulate, the estrogen build up of the lining continues, but without the usual ovulation associated progesterone. Thus, the hormone levels don't decline, and the lining stays up inside the uterus—your missed period.

If you have been several months without a period, a gynecologist may give you some progesterone in a pill form (eg Provera 10 mg for 5 days). Within 48-72 hours after stopping the progesterone your "progesterone blood level" will fall, triggering the release of the lining that has been building up. Many women report that these periods are very heavy-- as though several months of lining are shed.

Causes for not ovulating are multifold: thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with boyfriends/girlfriends, money), increased body weight, anorexia, rotating shifts at work, etc. In your specific case you certainly have enough stress from working two jobs to temporarily interfere with ovulations. Your TSH will either confirm or rule out thyroid as a possible culprit.

Lastly, the CBC, iron, B12 sound more like tests for anemia--not missed periods. Perhaps your MD is working up causes of fatigue as well (eg anemia, low thyroid, infections, etc.). With a schedule like yours it would seem fatigue would be inevitable.

Gosh, we hope your flow resets itself to its natural pattern within the next month or so. Certainly if you develop pelvic pain (eg ovarian cyst), don't wait, see your GYN for follow up.

Yours,
Jane


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